TY - JOUR
T1 - Stenotrophomonas maltophilia bacteraemia
T2 - 61 cases in a tertiary hospital in Denmark
AU - Ahlström, Magnus G
AU - Knudsen, Jenny Dahl
AU - Hertz, Frederik Boëtius
PY - 2022/1
Y1 - 2022/1
N2 - BACKGROUND: Stenotrophomonas maltophilia is an opportunistic pathogen and a dreaded cause of bacteraemia with 30-day mortality rates ranging from 14 to 69%. The purpose of this cohort study was to evaluate outcomes of S. maltophilia bacteraemia, at Rigshospitalet, a tertiary hospital in Copenhagen, Denmark.METHODS: We included all patients with a blood culture positive for S. maltophilia, from January 1, 2015 to April 1, 2020. We extracted data on antimicrobial susceptibility, treatment, central venous catheter intervention and severe haematological disease.RESULTS: Sixty-one cases of S. maltophilia bacteraemia were identified. The overall 90-day mortality was 18%. Sixty percent of patients had a central venous catheter intervention performed. Seventy-nine percent of patients were treated with trimethoprim/sulfamethoxazole (TMP/SMX). Patients with central venous catheter intervention had significantly better survival than those without (HR: 0.16 [95% CI: 0.03-0.73]). Severe haematological disease and patients, who received intensive care unit (ICU) care, were at higher risk of death than other patients (HR: 5.93 [95% CI: 1.18 - 29.94] and HR: 8.37 [95% CI: 1.79 - 39.20], respectively). We found no evidence that any antibiotic regime was superior with regard to 90-day mortality.CONCLUSIONS: We did not find evidence to support a change in the current standard-of-care regimen of TMP/SMX and CVC removal. Larger clinical trials are needed to guide such recommendations.
AB - BACKGROUND: Stenotrophomonas maltophilia is an opportunistic pathogen and a dreaded cause of bacteraemia with 30-day mortality rates ranging from 14 to 69%. The purpose of this cohort study was to evaluate outcomes of S. maltophilia bacteraemia, at Rigshospitalet, a tertiary hospital in Copenhagen, Denmark.METHODS: We included all patients with a blood culture positive for S. maltophilia, from January 1, 2015 to April 1, 2020. We extracted data on antimicrobial susceptibility, treatment, central venous catheter intervention and severe haematological disease.RESULTS: Sixty-one cases of S. maltophilia bacteraemia were identified. The overall 90-day mortality was 18%. Sixty percent of patients had a central venous catheter intervention performed. Seventy-nine percent of patients were treated with trimethoprim/sulfamethoxazole (TMP/SMX). Patients with central venous catheter intervention had significantly better survival than those without (HR: 0.16 [95% CI: 0.03-0.73]). Severe haematological disease and patients, who received intensive care unit (ICU) care, were at higher risk of death than other patients (HR: 5.93 [95% CI: 1.18 - 29.94] and HR: 8.37 [95% CI: 1.79 - 39.20], respectively). We found no evidence that any antibiotic regime was superior with regard to 90-day mortality.CONCLUSIONS: We did not find evidence to support a change in the current standard-of-care regimen of TMP/SMX and CVC removal. Larger clinical trials are needed to guide such recommendations.
KW - Anti-Bacterial Agents/therapeutic use
KW - Cohort Studies
KW - Denmark/epidemiology
KW - Gram-Negative Bacterial Infections/drug therapy
KW - Humans
KW - Retrospective Studies
KW - Stenotrophomonas maltophilia/immunology
KW - Tertiary Care Centers
UR - http://www.scopus.com/inward/record.url?scp=85112576794&partnerID=8YFLogxK
U2 - 10.1080/23744235.2021.1963470
DO - 10.1080/23744235.2021.1963470
M3 - Journal article
C2 - 34392797
SN - 2374-4235
VL - 54
SP - 26
EP - 35
JO - Infectious diseases (London, England)
JF - Infectious diseases (London, England)
IS - 1
M1 - 1963470
ER -